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Inside the Covid ward All of our patients who die, do so alone. There is nobody to hold their hand. Nobody to comfort them

Staff at a Covid ward. Photo by Neil Hall - Pool/Getty Images

Staff at a Covid ward. Photo by Neil Hall - Pool/Getty Images


January 6, 2021   6 mins

I begin my shift at 8am. Before I can even head to my allocated bay, a nurse is already asking for a doctor to help her. One of the patients won’t put on his mask and his oxygen levels are dropping. It takes me a few moments to get on my PPE before I can get to him. I try to talk to the man, but it’s difficult for him to hear me through my mask and the noise of all of the CPAP oxygen machines. He tells me that he’s tired of fighting, and that he wants to be left alone.

Through my mask I try to explain that he has been getting better, and that we wouldn’t have a place for him on the high dependency unit (HDU) unless we thought he had a good chance of survival. He tells me that I don’t understand what it’s like, desperately struggling to breathe, which is true. This goes on for around 10 minutes. Eventually, I have to take his request seriously. Perhaps it isn’t illogical for him to want to die peacefully.

In order for me to allow him to make this decision, I have to be sure that he understands the risks, so I ask him to explain to me what he expects will happen if he takes off his mask and doesn’t put it back on. He says he doesn’t know. I tell him that he has to understand that he will die and that he needs to say those words to me if that is what he really wants. Eventually we compromise; he will put his mask on for another hour, then phone his wife and tell me his decision. This man is 61.

I am allocated B Bay, in which there are five patients. My patients are mostly men, ranging from their early 30s to their 60s. This is younger than normal on HDU because — as I explained to the man — we only have beds for people with a fighting chance. I read their charts to update myself on what happened overnight.

Who dropped their oxygen saturations? Who needed their CPAP (Continuous Positive Airway Pressure) settings increasing? This comes via a tight mask that goes over your face to help you breathe by forcing air into the lungs at high pressures, keeping the airways open. I am told that it feels like you are suffocating.

Who crashed overnight and is now on the ICU (intensive care unit)? Who has died?

I then put on my PPE (FFP3 mask, hairnet, long-sleeved gown, gloves, visor) and enter the bay to examine the patients. I feel lucky to have this level of protection — my colleagues outside of the HDU only have surgical masks, which offer little protection against an airborne virus.

The patients don’t ask many questions, mostly because they need to spend all of their energy breathing. I try to work out if one of my patients isn’t answering my questions because she is delirious, because she doesn’t speak English, or because she is depressed. I work out that it is probably the latter; her notes say that her husband died just before New Year, from Covid. I try to remember every patient as an individual, since I can’t bring the notes into the bay to write as I go, but each crackly chest I listen to blurs into one. I summarise what I have found, for the consultant’s round later in the morning.

By this point, the blood test results should be back. I had been wondering why one of my patients was deteriorating — requiring more oxygen and at higher pressure — and his blood results provide me with a likely answer: a blood clot on the lungs. He is too unwell to enter a CT scanner, which would confirm this theory, so I treat him as if he has one, with higher doses of blood thinners. I corner the ICU doctor, who happens to be reviewing another patient on the ward at the same time, asking him to have a glance at my patient. He agrees that he will likely need an intensive care bed at some stage, but at the moment they simply don’t have one. I worry that my patient is going to end up with an emergency intubation, much more dangerous than a controlled one in ICU.

I now have to update relatives over the phone, since they are unable to visit. I always put this part off; I almost never have good news to deliver. Hearing people cry on the other end of the phone, knowing that I am them bringing news of the worst day of their lives, is heartbreaking. There is nothing positive that can be made from the words “your father is currently on the maximum support we can offer, and we are not sure if he is going to survive today”. I feel like a bad doctor because — to put it bluntly — I’m causing suffering rather than alleviating it. Why can’t I make them feel better?

We try to have our patients prone (lying on their fronts) since this opens up their lungs at the back and improves their oxygen levels. The patients hate proning, since the masks dig into their faces, their backs hurt and their arms go numb, and we do not have massage table-style beds with holes for their faces.

One of my patients has not managed to be prone at all. I speak to his wife, who tells me that he is very claustrophobic, and that might be why he has been resistant. She tells me that she has been pleading with him on the phone to try it, but hasn’t been able to persuade him. I ask her if there’s anything that has helped him in the past with his claustrophobia and she says sometimes watching a film on the iPad. But I don’t have the courage to tell her that he is nowhere near well enough to watch a film. She suggests a fan, so I arrange for a fan to be set up for the patient, and he manages to prone all day. I feel like a good doctor.

We have several patients who are not “fit” for ICU in the current climate. Before Covid, they most likely would have been given a chance, but not now. When we think that these patients have suffered enough, and are unlikely to ever recover, we start talking about making them comfortable. It’s partly that we need the beds for patients with a better chance, and partly that we feel it is cruel to keep these people suffering when their chances of survival are slim. It’s difficult to work out which of those is your true motivation.

The most distressing part of their struggle is the air hunger. You can spot these patients easily, as they grasp the masks to their faces with both hands and gasp visibly for air.

Once we decide to palliate someone, we give them morphine to reduce their respiratory drive, and ease this feeling. We give them benzodiazepines to lower their anxiety, antiemetics to stop them from feeling nauseous, and other medications to prevent them from needing to cough. We then take off their masks.

It is important that these medications are given before their masks are removed, otherwise they will die terrified and gasping. This decision is made for about two or three patients each day on my ward, out of 20 or so. However, this process does not always run smoothly. Sometimes these medications are prescribed but not given in a timely fashion, or at insufficient doses. With so many patients, we cannot keep an eye on them all; to watch whether what we are doing is working.

Once a patient is deemed to be dying, they are allowed one family member to see them for 15 minutes. The patient won’t be able to see their loved one’s face, since they will be wearing full PPE. Because the family member only has one shot at visiting, we need to accurately guess the patient’s time of death so that we can call them to come in. Sometimes we get this wrong, and the family never gets to see them. But all of the patients who die do so alone. There is nobody to hold their hand. Nobody to comfort them. Nobody to tell them they love them.

Towards the end of the day, two of my patients are deteriorating and destined for the ICU. Another doctor had an ICU candidate in her bay. They are all between 60 and 64 years old, none of them with significant comorbidities; all were working full time until coronavirus struck. They all now require 80% oxygen at high pressures, breathing at around 50 breaths per minute and tiring. There is only one ICU bed. I leave before the decision is made as to which of them will get the bed. I am sure that whoever doesn’t get it is likely to deteriorate overnight.

I pay for an Uber home, because at 9.30pm I can’t face walking in the January dark to the train station and spending over an hour getting back. I arrive home at around 10.15. In less than 10 hours, I will repeat the same day again.


Jane Smith is a pseudonym for a junior doctor in England.


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marian may
marian may
3 years ago

Heartbreaking and yet……..this is a normal story for so many people whether the cause of death is COVID or flu or pneumonia or cancer. Perhaps we need to seriously reconsider how we treat all people at the end of life and how we can increase our humanity, and not lose it out of fear. The idea that we can save every life no matter what the cost is contributing towards our inhumane practices. And then there’s the families left to grieve alone with no visitors, no kindly neighbours, no support from extended family. And the world poverty and starvation that our lockdown mentality is creating. Let’s open our hearts, have them broken, and rediscover our humanity around death and dying.

joe_falconer
joe_falconer
3 years ago
Reply to  marian may

This article could have been written during the 2017/18 bad flu season. The difference between now and then would be how the hospitals are now being managed and visitor policy. Just observing how Covid has somehow secured an extra special position in our response to health issues.

Overall, its as if the vast majority of people have lost sight of the invitibilty of human life expiration. The increasing life expectancy in the west seems to have imbued the masses with a blindness to reality of daily risk – today most of those demanding more restrictions are betting that they are not the ones who will lose their jobs, get cancer of have a cardiac event.

Last Jacobin
Last Jacobin
3 years ago
Reply to  marian may

If you die of cancer or pneumonia there is a good chance you would be able to die at home supported by a community palliative care team. Covid is so transmissible that this can’t take place without placing others (those who the dying would wish to protect) at risk of becoming ill.

I really hope you’re not suggesting this doctor was contributing to ‘inhumane practices’. That would be inhumane

larry tate
larry tate
3 years ago
Reply to  Last Jacobin

Sorry Mark, but I am suggesting this doctor, along all doctors in this planet are bent on inhumane practices regarding the dying patients they have in their hands.
More has to be done to educate our younger generations to get used to the idea of death, not to see it as the end but rather the beginning of whatever comes once we leave our bodies behind.
Covid kills not randomly, only the old, obese and infirm. It is a natural process which sadly most of the times is botched by the inhumane practices of our medical stablishment.

mhofmannjones
mhofmannjones
3 years ago
Reply to  larry tate

These dying patients (referenced in the article) are still working full-time in their 60’s. Hardly time to die.
Death is part of life, yes, but these deaths are not always expected.
I have been a nurse for 35+ years and have dealt with a lot of deaths. Some very peaceful some very traumatic. I agree that we can’t save everyone and the discussions around death and dying need to happen much earlier than at the moment. We are getting better at it by asking patients to have advance directives. What do you do with people who just can’t deal with it? Many opt out of being participants in their own passing for a myriad of reasons. This doctor is doing the most humane thing given the circumstances. I do not envy him/her.

Anne Poitrineau
Anne Poitrineau
3 years ago
Reply to  larry tate

“only the old, obese and infirm” you are wrong and it also sounds offensive and cold hearted. Covid will kill more of the “old, obese and infirm” than some other virus, but I can tell you about two young people without prior morbidity who died of Covid. Next: the practices in themselves might not be inhumane, it is the mode of administering them. We need to find a way to give this care humanely. What does that mean? improve on PPE so it is not so cumbersome, organise wards so that relatives can be present, more staff so they have more time and more emotinal resources. Without the virus, these people would have continued to work etc. They were looking after grand kids…Sorry, but to me, you sound like somebody who wants to pose as a philosopher on the meaning of life but you forget to be compassionate and do your research on what is really going on.

Paul Murchan
Paul Murchan
3 years ago

Really, you know 2 young, healthy people who’ve died of COVID? Since there’s only been about 400 of those (healthy under 60’s) in the entire country since the start of this, that seems highly unlikely! I’m sorry to appear crass, but are you being totally honest?

worldsbestbrewer
worldsbestbrewer
3 years ago

We can all come up with sob stories about him or her dying. Data tells us who become ill from covid and who dies. That is in the main old and ill. Decisions need to be made on data, not emotion. There are alwys exceptions.
I doubt you’d think twice of driving 24km and its associated risk of death. Roughly the same risk as dying from covid for under 65s.
Perspective.
https://www.euromomo.eu/gra

John McKee
John McKee
1 year ago

Very true.

Mark Corby
Mark Corby
3 years ago
Reply to  larry tate

Spot on.
Idiotically the NHS seems to regard death as failure. It’s not, it’s natural and has to be.
Every night when you close your eyes there is no certainty you will wake again, and one day you won’t.

Mr Bridgeford seems to think that is a tragedy, it’s not it’s reality.

Andrew Fisher
Andrew Fisher
3 years ago
Reply to  larry tate

Since death essentially involves the systems of the body breaking down, in many cases it isn’t a pretty sight, and never has been. We can read enough accounts of death in pre modern times to show this. Some people are lucky enough to die suddenly (though that is traumatic for their loved ones) or in their sleep. It’s not all the fault to modern medicine striving ‘too officiously to keep people alive.

I am 60, not sure I’d be ready to be given up on at an early stage. There is a difference perhaps with people at the upper end of a human lifespan.

Clearly though notwithstanding covid, too many people die in hospital in a rather futile struggle and we should put far more resources into the hospice movement etc to allow more people die in dignity.

Mark Corby
Mark Corby
3 years ago
Reply to  larry tate

Spot on.
Idiotically the NHS seems to regard death as failure. It’s not, it’s natural and has to be.
Every night when you close your eyes there is no certainty you will wake again, and one day you won’t.
Mr Bridgeford seems to think that is a tragedy, it’s not it’s reality.

johngrant4est
johngrant4est
3 years ago
Reply to  larry tate

“but rather the beginning of whatever comes once we leave our bodies behind.”
Believing that this is all there is (please don’t say you know better, and no, neither do I), isn’t it right that doctors and nurses should treat every patient according to their wishes? The critical point is that those who want to live aren’t being offered the same chance as they would in other times.

Elizabeth Agarwal
Elizabeth Agarwal
3 years ago
Reply to  marian may

Most people do not did like that.They have quite peaceful deaths.This is a nasty virus and it gives you a nasty death.

Stephen Easton
Stephen Easton
3 years ago

I am very sorry but I have seen more death than I would wish to. The cases I saw were not peaceful. They were tragic and hard. One of them included a non Covid respiratory illness at the end.

What the doctor describes is correct. For sure.

Covid is horrible. But so are the other ways that people die. Based on what I have seen. Unfortunately, this is part of life. It does not feel correct to say that Covid is something totally outside of all prior human experience. Sadly.

Muscleguy
Muscleguy
3 years ago

I have a personal horror of dying like that, struggling to breathe. I have asthma, without a flu vax I dice with pneumonia every winter. With drug resistant bugs on the rise it would only be a matter of time.

Covid did not fill my lungs more than a bit, then it did not get worse. I had a cough, one, when I changed position and the fluid shifted. i fear flu more in that respect. As I age and my immune system becomes ever less responsive to the flu vax so my chances go up.

I’m also a lifelong distance runner so I’m in a good place physically. But I have a PhD in Physiology as well so I’m not starry eyed. My speciality is muscle and I know how kids, almost all boys, with muscular dystrophy die. The lucky ones are those with bad immune systems who get infections. I have given of myself scientifically to try and stop that happening.

worldsbestbrewer
worldsbestbrewer
3 years ago
Reply to  Muscleguy

If you have asthma you may actually have a better chance of surviving covid than the rest of us! Especially if yr Vit D levels are way up.

Scroll down to the bar chart.
http://www.drdavidgrimes.co
Having watched a Dr Bartlett being interviewed on his successful use of Budesonide, an inhaled drug to treat covid I emailed Dr Grimes. It was quite uplifting to talk with an open minded doctor who forwarded the info to the trial director.

Cee Bee
Cee Bee
3 years ago
Reply to  marian may

Absolutely agree – we have become utterly inhumane if we are allowing people to die alone. I agree that being an ICU doctor at present is horrific and there are no easy answers but surely we should not be sinking to this type of end of life care.

7882 fremic
7882 fremic
3 years ago

I remember when we did this to my father, killed him with the final morphine dose. In my young years, after I moved to USA, I had worked in an old people home of last resort. It was where the people with no money and family went to die, mostly totally Alzheimered and lost souls. It was a hell hole, hugely under funded, as they were in those days.

Every time a resident would see your uniform they would call ‘Nurse, Nurse’ as they needed something but we were too busy. We would tie them with a seat belt to the wheel chairs and tie one wheel so they would spin in circles, unable to do what they all wanted to do, to go home. ‘I want to go home’ they would tell you all day – not knowing their home was now lived in by someone else and all their stuff in the landfill or junk shops, usually years ago, and family off in another state and not coming back to see them. Then they eventually would go onto NPO, nothing by mouth, and soon would die of lack of water, all were naturally on DNR (do not resustate, or code). The workers were tough nuts, minimum wage, hardened or gone, like I was gone after 4 months.

So a few years ago I brought my old father in his late 90s to live with me in the USA, (he was in London, I moved back to London to care for him) ,getting him away from the horrid NHS clutches where they dropped him in hospital giving him vascular dementia when in for a stomach complaint – and then only released him to family if we had 4, TWO PERSON, visits a day from a care company. Those guys did nothing but collect fat checks 688 pounds a week – for nothing as we did the care mostly, but we could not fire them or the NHS would take him and put him in a care home at 1200 pounds a week! NHS had total control, and made us spend and interfere and were Bas**rds. NHS has a mission to get any savings out of old people, and spent on their favorite contractors. So I took him to USA and cared for him ourselves. Did it all, and after 6 months he was finished, he had crossed the line between living and suffering. The doctor and his nurse had given us morphine to administer when his breathing became too painful. We all know this it to kill him as it makes the not breathing not painful, so they stop breathing and die. And one night we did, and he died.

It is how it goes. My old mother lives with me, and we will care for her till she dies, again in my house. The wheel of life just keeps on. Just a story to say how it is with the non-covid end of life.

David Lawler
David Lawler
3 years ago
Reply to  7882 fremic

It’s true. Everyone dies in the end. Its about time we all accepted this fact.

Geoffrey Simon Hicking
Geoffrey Simon Hicking
3 years ago
Reply to  David Lawler

So long as we work towards making sure that people can die comfortably, peacefully, and even, dare I say it, with a minimum of fear. Dying happily? Is that possible?

We should not have the end of our lives be utter hell, ending all that hard work to improve ourselves and our circumstances.

susiesukes21
susiesukes21
3 years ago

As a hospice volunteer i can say that it is possible…

woogie15
woogie15
3 years ago
Reply to  susiesukes21

If you can afford it. I too am a Hospice volunteer and have seen them ready to transfer a near death patient out because of money. Blessedly, she died.

MJ Reid
MJ Reid
3 years ago

My mum died happy in care. The residential unit she was in was brilliant. And she died in her bed at night from a heart attack or a stroke but was peaceful. She had a very happy 9 months doing things she didn’t do at home. And even though she had dementia, she was treated with dignity and respect. It can and does happen.

Andrew McIntosh
Andrew McIntosh
3 years ago
Reply to  7882 fremic

I spent eighteen years working in residential aged care and saw everything you’ve seen. It’s an industry that chews people up and spits them out. Never again.

Signme Uplease
Signme Uplease
3 years ago
Reply to  7882 fremic

This culture hates old people, the vulnerable, the young. If you aren’t young, male, healthy, obedient, you are treated as a burden, unworthy of minimal care. Indigenous cultures may not have all the fancy medicine and science, but what they do still have is their humanity.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Signme Uplease

Signme, you are right that traditional cultures often treat elders with more care. Don’t see the link between being treated better as a man, women get more medical treatment than men routinely, but there is one important point we must bear in mind. Primitive cultures tend to die a lot younger, a tribesman at age 80 has done really well. Their elderly tend to die quickly also, they rarely have lingering deaths, complete with alzheimers and incontinence for years on end. Medical treatment can be a mixed blessing.

kecronin1
kecronin1
3 years ago
Reply to  Aaron Kevali

You make a point often missed. Medicine has allowed the body to continue on but it can lead to non living living.

Alison Wren
Alison Wren
3 years ago
Reply to  Aaron Kevali

women are probably getting treatment for gynaecologist reasons! and more autoimmune diseases. various issues around our sexed bodies. but very little female specific research into drug treatments etc. I recommend reading “invisible women” if you doubt me!

cranialbob
cranialbob
3 years ago
Reply to  Alison Wren

Women see doctors 9 times more frequently than men. Primary reason: men don’t ask for directions when lost either. Going to a doctor is giving up your will and surrendering and admitting that you need help; not in the cards for most men….until in an emergency situation. I recommend going to medical school if you doubt me.

J J
J J
3 years ago
Reply to  Signme Uplease

Isn’t the problem that if you add the young, the old and the ill altogether, you are talking about half of society (at least in the West). It’s difficult for one half of society to spend all of it’s effort and time trying to support the half of the population that can’t support itself? We need to find a way of making people more self sufficient.

Andrew Martin
Andrew Martin
3 years ago
Reply to  J J

China’s take on this is the young and productive come first for the vaccine and the old and infirm come last.

J J
J J
3 years ago
Reply to  Andrew Martin

It scares me that China knows something they are not telling us.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  7882 fremic

I’m sorry to hear this story, and it matches my own exerience of working in a care home briefly for four months. All these people who screech how much we must protect the elderly seem to care not one iota for those who have been with us for a while now. There is no suffering quite like being old and demented in a modern care home.

J J
J J
3 years ago
Reply to  7882 fremic

I don’t understand the comments about the NHS. I am not aware of any legislation or policy that would allow them to insist on any form of mandatory care or treatment for anyone. Unless a person is sectioned under the mental health act or perhaps under situations of child abuse.

7882 fremic
7882 fremic
3 years ago
Reply to  J J

I tell you they have total authority. After he got his blow to the head in hospital he became really confused. To take him home there was a meeting of his doctors, nurse, with a care advocate and us. They said to be released he had to have 4 visits a day (2 people per visit, as they have to lift him, but I did all that) from a approved home care company. We were given a list and picked one.

We were told we MUST use them (or change to another on the list) or he would be taken from us and put in a care home! They were serious. The contractor would report to them if we fire them and he would be taken. Because he was so confused the NHS declared him a ward of the state (I do not know the proper term) and so they have absolute power to remove him.

We had the minimum time of visits, but it was out of pocket 688 pounds a week! NO gov assistance as they owned their house!

The carers were mostly poor, and tired, and I would not trust them if no one was watching, to be diligent. Every care company I called was owned by migrants from India or Africa, as were the carers.

I appealed as there was my mother, my sister, and me, and I am strong enough to carry him, and we can do personal care. They said no. I took him back to USA where I turned my guest cottage into a hospital room and house for my mother. We saw a doctor who gave us medicines, we had a one hour a day carer in for morning baths ($30 a day), but did the rest. We also had a nurse visit weekly, and she could prescribe medications under the doctor’s license. We bought and rented the equipment. It cost a month what we spent in two weeks in London. (NHS had provided all the equipment) But we were free of all the hassle. This also allowed me to return home and to work – I am self employed and can take time off as I see fit.

He had the one doctor visit where I took him in to our doctor, and then just the nurse weekly for a quick visit. It worked great, he was happy till the breathing got too bad (6 months, he was mid 90s in age). Being in bed too long makes the body shut, and he was helpless, could not even raise his arms so the end was inevitable. Here you can care for your elderly. I would imagine same in UK if you do not have to get them from hospital, but they just age in your house, but they still may require the carer visits, I do not know.

The home care advocate at the hospital, she has her own office in hospital, seems NHS, but is NOT. She is a rep of the care companies, and works with them and NHS, she is paid by the private care companies!!!! She is a paid shill in my view, but has full authority!

Muscleguy
Muscleguy
3 years ago
Reply to  7882 fremic

The hospital did not give your father vascular dementia. He may have been diagnosed with that while in the hospital but if you think it is transmissible you have misunderstood.

7882 fremic
7882 fremic
3 years ago
Reply to  Muscleguy

He took a blow to the head and came out different.

iainmaccallum10
iainmaccallum10
3 years ago

“I then put on my PPE (FFP3 mask, hairnet, long-sleeved gown, gloves,
visor) and enter the bay to examine the patients. I feel lucky to have
this level of protection ” my colleagues outside of the HDU only have
surgical masks, which offer little protection against an airborne virus”

Good point on surgical masks.

stephen f.
stephen f.
3 years ago

No doubt that statement will be banned from social media…

Last Jacobin
Last Jacobin
3 years ago

Yes. They offer little protection in an enclosed environment with a load of sick Covid positive patients breathing the same air as you. Completely different scenario from being in a supermarket where wearing a mask might offer a percentage (be it 1% or 10% – I don’t think anyone knows) chance of the wearer who doesn’t know they’re infected infecting their neighbour.

Mora Fields
Mora Fields
3 years ago
Reply to  Last Jacobin

The recent Chinese controlled, peer-reviewed study with 10,000,000 subjects concludes that there is no asymptomatic transmission.

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
3 years ago
Reply to  Mora Fields

I would certainly hope that there was next to no asymptomatic transmission ! – this study was conducted after 70 days of Chinese totalitarian lockdown.

The important parts of the study distilled by the BMJ :
The researchers said that their findings did not show that the virus couldn’t be passed on by asymptomatic carriers, and they didn’t suggest that their findings were generalisable.
They said that strict measures”such as mask wearing, hand washing, social distancing, and lockdown”were successful in reducing the virulence of SARS-CoV-2 in Wuhan and that asymptomatic people in Wuhan may have low viral loads. This means that the finding cannot be applied to countries where outbreaks have not been successfully brought under control
Fujian Song – “there is plenty of evidence elsewhere showing that people infected with covid-19 may be temporarily asymptomatic and infectious, before going on to develop symptoms.”

shannon
shannon
3 years ago

26 upvotes for a recurring and simple misunderstanding. In our case, the general public, masks are for OTHERS in case you breathe out the virus onto them. This simple fact seems to elude people who generally exhibit the selfish behaviour of thinking its all about THEM.

J StJohn
J StJohn
3 years ago
Reply to  shannon

The problem is that:
The masks are too coarse to restrain the virus
You exhale sideways onto others instead of down and away
Worst in so far as they work , they filter the virus so that only the most ‘contagious’ ones survive to reproduce we have literally evolved a worse virus! You cant make it up.

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
3 years ago
Reply to  J StJohn

The viruses are contained in water droplets of various sizes. It’s these that the masks catch. The viruses don’t have legs. If you adjust your mask properly then it can fir well enough to limit sideways spread. Nice visualisation of droplet and aerosol dispersion with / without masks in the NEJM here :
“Visualizing Speech-Generated Oral Fluid Droplets with Laser Light Scattering”

Stephen Easton
Stephen Easton
3 years ago

The evidence is mixed. Until 2020 there does not seem to be a single study that showed a benefit of masks in a community setting.

Doctors originally wore them in operating theatres to prevent them putting saliva on wounds. Not to stop viruses. The practice started before viruses were understood.

Various control studies even dispute the efficacy of masks in an operating theatre. Orr (1981), for example, studied effects on post operative infections at Severalls Hospital if doctors stopped using masks. Surprisingly, the study found no effect.

Clearly, the virus goes somewhere if one exhales. Aerosol must be distributed with CO2 or else one suffocates. Virus in water droplets presumably sticks on the mask. What happens to it afterwards is unclear.

The reality is that our understanding of how respiratory illnesses spread seems super weak. Despite what we are told.

If masks were beneficial then I genuinely wonder why an animal somewhere has not evolved them through evolution. Viruses are older than mammals. There would have been time to evolve masks and all animals suffer from viruses. My guess is that keeping the airways clear gives an evolutionary benefit to animals. Worth pondering that if one wants to wear a tight mask for 8 hours at a time.

Last Jacobin
Last Jacobin
3 years ago
Reply to  Stephen Easton

i think there’s a theory we have nasal hair to try and prevent droplets getting into our respiratory system. Interesting point though – maybe if we had breathing holes and separate eating holes (like whales?) we’d be more resistant to airborne infections.

Also, viruses can be transmitted via saliva so the original idea wasn’t so daft.

Muscleguy
Muscleguy
3 years ago
Reply to  Stephen Easton

I have seen so many people handle the middle of their masks while putting then or taking them off. That is where the viruses are, yours and other people’s.

People then rub their eyes or put their fingers in nose or mouth, likely unconsciously. It isn’t until you have to do something like surgery or tissue culture that you realise this and work out ways to stop yourself doing it. Wearing surgical gloves helps.

Aside from the eyes being open to droplet viruses with just a mask, the numbers I see without the nose covered, the hands are likely the big thing which borks masks being effective in community settings.

Handle your masks by the straps people. Don’t touch your face until you are home and have washed AND dried your hands. Sterilise cloth masks after every trip out. A hot steam iron will do this.

kecronin1
kecronin1
3 years ago
Reply to  Muscleguy

A friend of mine ended up with a nasty staph infection that erupted in her cheek area of the face. She had helped clean the apartment of her ex-husband who had come home from the hospital. I am sure in cleaning she picked up the virus and rubbed her face. Where sans mask the staph might have dissipated, it did not with her mask. It did become quite serious with her doctor concerned it might make its way to her brain. Thankfully hers is not a common experience- she had been run down and being run down never leads to a good outcome – but it is something to consider as we wear these filthy things day in and day out. After your first breathe they are contaminated.

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
3 years ago
Reply to  Stephen Easton

Efficacy of masks. Yep, the research is unclear, however we aren’t in an operating theatre in this current scenario. In this situation I would suggest that every little counts (to reduce virus transmission) and unless you have severe breathing problems, wearing a mask does you no harm.

CO2 has no problem percolating through mask material – the gas molecules are smaller than viruses and smaller than the interstices of mask materials.

How respiratory illnesses spread. People meet and interact. There are obvious variables, viral load, time, environment, susceptibility of potential host.

Animals evolved immune systems of variable effectiveness – this just involved producing new cell lines that already existed rather than a complicated physical structure.

Tight masks. Well, amazingly health care professionals like Dr Smith seem to manage somehow or other for 8 hours or so.

John Alexander
John Alexander
3 years ago

No the research is very clear. Medical Masks provide no benefit in a non-pharmacuetical enviroment.Just as Industrial masks are not used in medical enviroments.

People have confused the purpose of medical masks. They are for use in a medical sterile enviroment specifically and essentially to protect the patient from spittle, dribble and snot falling or bieng sprayed if a doctor or nurse or assitant sneezes into the surgical area.

People are so easily fooled. They are in fact dangerous when worn continiously. A doctor does not wear a surgical mask or at least the same mask for 8 hours.
Are people aware that the virus can also enter through the eye? Yes the eye. So what must we now all wear goggles?

I would suggest you read these two references.

Xiao J, Shiu E, Gao H, et al. Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings”Personal Protective and Environmental Measures. Emerging Infectious Diseases. 2020;26(5):967-975. doi:10.3201/eid2605.190994.

Masks Don’t Work:
a Review of Science Relevant to Covid-19 Social Policy
https://vixra.org/abs/2006….

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
3 years ago
Reply to  John Alexander

Thank you for these 2 references.

The Xiao paper is quite a nice review – it has very good appendices including a quality assessment of the facemask studies they chose to include in their meta analysis. This bears reading in detail because their comments in that section don’t necessarily square with their conclusions in the discussion section.

The vixra paper is a preprint and is a narrative, not a systematic review. The one comment in this paper for which I have some sympathy is :
“Why There Can Never Be an Empirical Test of a Nation-Wide Mask-WearingPolicy”
although amazingly, someone has recently attempted this using some sophisticated statistical methodology :
Face masks considerably reduce COVID-19 cases in Germany Mitze December 22

In the general spirit of sharing I would commend to you the Cochrane review (because Cochrane has the most stringent systematic review protocols) :
Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane
Database Syst Rev 2011
and a similar systematic review with similarly fussy quality criteria :
Efficacy of face mask in preventing respiratory virus transmission: A systematic review and meta-analysis Liang Travel Med Infect Dis 2020

Personally I view mask wearing as just part of the armoury but an important part – it is a constant, visible reminder to be respectful.

7882 fremic
7882 fremic
3 years ago

Does your mask weigh a couple pounds at the end of a day, because you exhale that amount of water. You say it catches droplets, but they then evaporate and are dispelled with any virus as an aerosol. The mask just lets the virus out as a cloud rather than droplets.

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
3 years ago
Reply to  7882 fremic

Erm … no
See
Respiratory virus shedding in exhaled breath and efficacy of face masks Leung Nature Medicine April 2020
“Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols…”

Barry Sharp
Barry Sharp
3 years ago
Reply to  shannon

Surely if the virus can get out it can get in? Or are you suggesting that doubling up is the critical factor.

worldsbestbrewer
worldsbestbrewer
3 years ago

And are you helping yourself with th elikes of Vit D?
http://www.drdavidgrimes.co

Alison Houston
Alison Houston
3 years ago

It sounds just like when my mother died of pneumonia,in 2008, when my sister-in-law died of pneumonia in 2010, with M.S., when my father-in-law died of pneumonia in 2000, with cancer. The only difference being that I saw my mother, my brother saw his wife, my husband saw his father, the day before they died, without having to wear PPE fancy dress. People do die alone. Some people cannot die, cannot let go, when their loved ones are present. Indeed it is best to allow people to die in peace. Thank you for making your patients’ passing as comfortable and peaceful as possible, but don’t lay the awfulness of it on with a trowel, you are used to it by now, and many of us reading have witnessed it. Death is a natural a phenomenon.

Robin Whittle
Robin Whittle
3 years ago

Everyone acts as if severe COVID-19 symptoms are inevitable for some people, but this is not the case. The primary or sole cause of these is weakened and dysregulated (hyperinflammatory, self-destructive) immune responses. The primary cause of this is inadequate 25 hydroxyvitamin D, which is needed to drive the autocrine and paracrine internal signaling functions of immune cells. Search for “Vitamin D autocrine signaling – illustrated explanation” which cites “An autocrine Vitamin D-driven Th1 shutdown program can be exploited for COVID-19”.

Please see “Effect of Calcifediol Treatment and best Available Therapy versus best Available Therapy on Intensive Care Unit Admission and Mortality Among Patients Hospitalized for COVID-19: A Pilot Randomized Clinical study” where hospitalised COVID-19 patients were given 0.532mg of 25OHD calcifediol and generally recovered quickly. Intensive care rate went from 50% to 2% and deaths went from 8% to zero.

Please also search for Paul Marik and colleagues’ “MATH+ protocol” for better ways of treating COVID-19 patients – but they would do even better with calcifediol AND bolus D3: “25plusD3”. (Trying to be brief and avoid URLs.)

Zinc, vitamin C, magnesium, selenium, B vitamins and other nutrients are also helpful, but nothing compares with the harm done by inadequate vitamin D. This is easy to fix in a week or so with supplemental D3. For urgent cases – those in hospital – you need 25OHD calcifediol, since D3 takes a week or so to be converted to 25OHD in the liver.

David Stuckey
David Stuckey
3 years ago
Reply to  Robin Whittle

So I guess everyone in the NHS is totally unaware of Vit D-why do you think that? I take 2000 IU per day based on science in the past.

Alka Hughes-Hallett
Alka Hughes-Hallett
3 years ago
Reply to  David Stuckey

It might not be the hospital protocol . I have heard of doctors treating themselves & their patients with high dose of vitamins both C &D and they have had remarkable outcomes

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  David Stuckey

Probably dismissed as fake news, it’s like the hydroxychloroquine scandal all over again.

Chris Milburn
Chris Milburn
3 years ago
Reply to  David Stuckey

There is no interest in VitD because it’s not patentable. If any patentable drug showed similar associations/effects it would be world news, and some company would have already made a billion dollars.

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
3 years ago
Reply to  David Stuckey

Not totally unaware at all. See Queen Mary University of London CORONAVIT study. Fully enrolled with 5,000 participants !

“will
run for six months and involve more than 5,000 people to find out
whether a ‘test-and-treat’ approach to correct people’s vitamin D
deficiency during winter will reduce the risk and/or severity of
COVID-19 and other acute respiratory infections.”

In the meantime one Spanish study in ICU patients showed benefit and one Brazilian study showed none. So jury still out.

Michael Cowling
Michael Cowling
3 years ago

Try googling Vitamin D for all.

Muscleguy
Muscleguy
3 years ago
Reply to  David Stuckey

Be careful, overdosing on VitD causes disregulation of glucose metabolism. I took too much and started hitting the wall on my runs after only 2 miles.

You may not exercise and find this but your brain and kidneys and other organs are obligate glucose users so if your glucose metabolism is impaired so your cognition might be as well.

VitD is fat soluble so it is stored, which makes it easy to overdose.

hughrosetrian
hughrosetrian
3 years ago
Reply to  Muscleguy

Drink to much water and it will kill you too! You overdosed – silly boy!

Michael Cowling
Michael Cowling
3 years ago
Reply to  David Stuckey

About ten years ago I had acute Vitamin D deficiency, and was feeling absolutely flat. I went to the doctor (Birmingham, UK) and had a blood test and they didn’t test for Vitamin D. In the NHS view, only BAME people suffer Vitamin D deficiency in the UK.

hughrosetrian
hughrosetrian
3 years ago
Reply to  David Stuckey

I am taking part in the University trial at present!

worldsbestbrewer
worldsbestbrewer
3 years ago
Reply to  Robin Whittle

Vit D out there. Trials done. UK NICE doesn’t like the trial so dismisses it and D. Our system is broken or perfected whichever way you look at it to exclude anything that is non pharmaceutical.
http://www.drdavidgrimes.co
http://www.drdavidgrimes.co

ralph bell
ralph bell
3 years ago

I am confused, as the writer says that they only take cases likely to survive but later says they have no good news for relatives. I am also confused since all the data illustrates that deaths are of average 82 yrs yet the writer advises their patients are majority in the ICU in their 60’s and 30-50 in the HDU. It does seem that the situation is being layed on thick here, whilst the medical staff working in a HDU oor ICU will be used to dealing with people needing high levels of care and higher risk of death. The medical staff also have chosen this job role and will have the emotional strength to cope. In my response I would still salute hard working committed staff who are doing their best in difficult circumstances.

Steve Swales
Steve Swales
3 years ago
Reply to  ralph bell

I too am conscious of this average age figure of ~82 years, which seems to have been around for a few months now. One of the problems we all have in comprehending this illness is the paucity and selectivity of the information we are permitted to receive. Does anyone know whether the average age of the unfortunate victims is still 82?

Jean Redpath
Jean Redpath
3 years ago
Reply to  Steve Swales

It is not in South Africa. Here anyone over 55 is considered at risk.

The 2nd largest age category of deaths in the Western Cape province (which has the most complete data) is age 51 to 60 (22 percent of deaths). People under 50 comprise 21 percent of deaths, 61 to 70 comprise 27 percent. The remainder (30 percent) are older than 70.

The age profile was much older earlier on (as the weakest died first).

Juilan Bonmottier
Juilan Bonmottier
3 years ago
Reply to  Jean Redpath

Does that lower age reflect the reported propensity for members of BAME (apologies, I don’t like that reductive acronym but here it is a useful shorthand) to suffer worse effects and mortality from the virus?

John Alexander
John Alexander
3 years ago
Reply to  Jean Redpath

Only if you believe government figures. All over the world the various influnza like deaths are automaticaly clasified as covid caused or realated. It is what these governments use to terrorise the population and to justify their actions.
There is clear evidnce that statistics are manipulated as are the postive tests are being called “cases”.
PCR cannot distinguish between “live” viruses and inactive (noninfectious) viral particles or shattered particles and therefore cannot be used as a diagnostic tool ” For this reason, it is grossly misleading to refer to a positive test as a “COVID-19 case. – Go look at PANDA for info for South Africa- link – http://www.coronavirus.afri

Last Jacobin
Last Jacobin
3 years ago
Reply to  Steve Swales

There’s lots of info out there – use Google and look for ONS, NHS or government sites that record age profiles of those who die, what life expectancy is at what age of life, how many people have underlying conditions and so on. Not all the information wanted is out there – information on the nature or severity of pre-existing conditions or prognosis isn’t there detailed and I doubt it will be until medics are able to undertake detailed analysis at patient record levels of what happened. (They’re a bit busy at the moment).

If you don’t trust ONS or NHS or Government sites then you can always get lots of misinformation from unaccountable sources on youtube.

Chris Milburn
Chris Milburn
3 years ago
Reply to  Steve Swales

I believe it is around 80 in Canada, with about 75% having 3 comorbidities, and 98-99% having at least one comorbidity.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Chris Milburn

It does make you think, doesn’t it? I think that at age 82 (or thereabouts) I would accept that every day is a gift, and I would like to spend it with others.

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
3 years ago
Reply to  Steve Swales

Almost correct. Provisional figures at ONS here on a slightly squiffy Excel spreadsheet :

“Average age of death (median and mean) of persons whose death was due to
COVID-19 or involved COVID-19, by sex, deaths registered up to week
ending 2 October 2020, England and Wales”
No figures that I can find on the ONS website for the latest debacle.

Actuarially (you know those people who deal with death and destruction every day of the week) 80 – 89 year olds in the UK right now, with 2 long term conditions can expect to live for another 5 years at least.

Muscleguy
Muscleguy
3 years ago

indeed, once you get to 80 your life expectancy goes up, not down. It’s only when you get to 98 or 99 that it starts to go down again. This is part of what encourages those who think we can live longer.

Anne Poitrineau
Anne Poitrineau
3 years ago
Reply to  Steve Swales

I am not sure they have updated their stats. from what I see around me (I am a teacher), the patients are getting younger. Even people who were not very ill get long Covid. I must say this: I work in an environment where people are not overweight. They are of working age, they got ill. Two died. One has long Covid, my cousin also has long Covid, my partner’s sister has long Covid. The doctors are a little baffled by long Covid and nobody seems to know how to support and treat them.

Susan Lundie
Susan Lundie
3 years ago
Reply to  ralph bell

With respect, as a retired frontline RN/RM, I recognise that nothing is being laid on thick here. I’ve worked in some pretty tough circumstances over the years, and incidentally spent 8 very sick weeks in the summer of 2019 (though not thankfully with the breathing problems these poor folk have) and experienced the care given by similar hard working doctors and nurses from the patient’s side.
No matter what training has been given, nor whether you have chosen your role, there can be nothing to prepare you for the utter emotional, intellectual and physical exhaustion that this present situation will bring. I think this is a very adequate description of the fortitude and empathy for the patient that so many of our frontline health professionals are displaying. One does develop a certain degree of self protection, otherwise one could not continue day after day, but they are otherwise no different from you or I.
That is not to say I have not observed your final comment. Thank you.

Nigel Farrah
Nigel Farrah
3 years ago
Reply to  Susan Lundie

With respect I can do without the trowelled on sentimentality. This in no way matches my experience of elderly relatives catching covid let alone people much much younger described here. This virus is far from a death sentence even in a care home with no icu let alone a hospital with one. To get me to empathise you’ll have to explain to me why my experience of a dozen people in their 80s and 90s surviving (one died who was already receiving end of life treatment) this virus in a care home is so different to those dying in this account with far far more medical support. I know when I’m being told a story.

Last Jacobin
Last Jacobin
3 years ago
Reply to  Nigel Farrah

The reason for the difference is because you don’t work in an HDU in a hospital and she does.

I live in a city and see very few cows every day but I read an article by someone who lives in the country who sees them every day. How do you explain that? I know when I’m being told a story.

Nigel Farrah
Nigel Farrah
3 years ago
Reply to  Last Jacobin

I don’t work in a care home with minimal medical support either but I know what happened to over a dozen elderly people with zero chance of being taken to hospital.

Anne Poitrineau
Anne Poitrineau
3 years ago
Reply to  Nigel Farrah

Is your real name Nigel Farage? That’s the kind of thing he would say. Your disparaging the “sentimentaliy” demonstrates you have no empathy. You may think of yourself as an empathetic person because you love your family. Loving one’s family is nothing special, nearly everybody does, and Hitler loved Eva Braun. The desirable/remarkable thing is to empathise for others. Of course the virus is not an automatic death sentence, it is not Ebola. But it kills 5x more than a bad flu outbreak, and we still do not understand it, and long Covid is not a joke and my previously very active, 54 year old cousin knows all too well about it.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  ralph bell

The final self-pitying tone at the end rather irritated me. I am stil waiting for the COVID hysterics to answer my question about the average age of patients who die from COVID, 82.4 years. Yes it’s difficult, but made much more so by the horrific strictures made upon patients and who can see them.

Nigel Farrah
Nigel Farrah
3 years ago
Reply to  ralph bell

You think it’s being trowelled and I agree with you. This anonymous account is worth far less to me that my actual experience of the virus which is: Two relatives in their nineties contract covid from a carer along with a dozen other residents. One dies who was already receiving end of life care. The rest survive after a fortnight of exhaustion, respiratory infection and diarrhoea. They received no specialist medical care. So does that sound like the same illness? I don’t think so and therefore I’m sceptical of this anonymous story. There is after all no need for anonymity to convey this account is there?

LJ Vefis
LJ Vefis
3 years ago

And this (one reason) why deaths in private homes are consistently well above average this year. This sounds brutal for all concerned. Surely most people would rather die at home with family than end up being treated like this.

Martin Z
Martin Z
3 years ago
Reply to  LJ Vefis

I don’t mean to be rude, but what on earth are you talking about? If you *knew* you were going to die, perhaps you’d rather die at home. But most survive – you surely don’t mean you’d rather die than be ‘treated like this’ and live?

LJ Vefis
LJ Vefis
3 years ago
Reply to  Martin Z

Sorry, I’m talking about older people here. If I were an unwell 90-year-old with chest pains or struggling to breathe, I would rather stay at home if hospitals are as inhumane as this (I know, I know – the virus is inhumane too).

LJ Vefis
LJ Vefis
3 years ago
Reply to  LJ Vefis

I must add – the staff are obviously not inhumane! I have a hundred reasons to be thankful for the humanity of all hospital staff.

Anne Poitrineau
Anne Poitrineau
3 years ago
Reply to  LJ Vefis

You might not be able to stay at home anymore, if nobody can assist for cooking, cleaning (yourself and your environment) etc. There is a long stretch between being incapacitated and dying. Not everybody will have family members/friends who can help.

Muscleguy
Muscleguy
3 years ago

Amen to that. I have viral meningitis. I live alone. I have limited physical capacity or it comes roaring back. Yet I must cook, clean, perfunctorily (my house is a tip), go out for food and paracetamol. It is far from easy.

The saving grace is that my virus is just a cold virus. I’ve had a cold for 7 weeks and being fit I only get mild symptoms. So it’s the meningitis itself which is most of the burden. I take stuff to ensure I don’t have a headache when I go to bed. I wake up with one nevertheless. That and a stiff neck.

John Alexander
John Alexander
3 years ago

“CPAP (Continuous Positive Airway Pressure) settings increasing? This
comes via a tight mask that goes over your face to help you breathe by
forcing air into the lungs at high pressures, keeping the airways
open. I am told that it feels like you are suffocating.”

A little over the top. It does not fell anything like the author describes and it does not “Force” air into the lungs.

I sleep with CPAP everyday, The pressure is very low and controlled and slowly ramped up. One you are used to it the ramping function is seldom used. It basically keeps the airway passge open and stops the soft palate collapsing closing the airway.

Imho this article is writtes to terrify people.

Last Jacobin
Last Jacobin
3 years ago
Reply to  John Alexander

Surely that would depend on the pressure? Which might be higher for those whose lung function is sufficiently impaired to mean they are in HDU or ICU rather than at home.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  John Alexander

That is exactly what it is written to do, but may not be wholly false. People who die in hospital now are desperately alone. And we will all know who to blame when this is over – Mr Johnson, Hancock, the medical staff who went along with it all, and ourselves.

Juilan Bonmottier
Juilan Bonmottier
3 years ago
Reply to  Aaron Kevali

Whilst I can’t go along with “God I hate nurses” I would share that I have seen many (many) appalling and atrocious experiences of nursing care; most have been of an adequate, ‘good enough’ standard, and some few have been beyond brilliant. It drives me to distraction however when the whole collective group are labelled indiscriminately, and forever it seems, as saints and angels. Perhaps this goes for the whole NHS experience -it’s time we looked at it truthfully -many people’s experiences of this service really are pretty bad when considered objectively -not wishing to detract in any way from the things it does extremely well, but there is such a tendency to idealise it -which does both the public and the practitioners a disservice.

Aaron Kevali
Aaron Kevali
3 years ago

I have amended my comment, you are right. My general experience is valid though. *Most* of them treat patients like ‘bodies’, needing treatment and inputs, with almost no concern for the actual human soul they are dealing with. And any nurse who takes part in a Tik-Tok video should be shot. If this situation is as horrendous as they claim, why are they dancing!? It is grotesque.

Muscleguy
Muscleguy
3 years ago
Reply to  John Alexander

You are used to it, the people in the hospital, very ill, isolated and unused to it will react differently to you. They hope not to have to get used to it, you know you have to so have made accommodations.

John Alexander
John Alexander
3 years ago
Reply to  Muscleguy

The point remains that it is nothing like as described by the author. It is quite bearable unlike having a tube shoved down your throat.

hazeyqq
hazeyqq
3 years ago
Reply to  John Alexander

I asked about CPAP in my response to this article. My close relative, like yourself, has to use it to sleep. Before it was prescribed the number of times they would stop breathing while trying to sleep was found to be so bad I couldn’t believe it. It was all measured at a sleep clinic though.
People may say “but you’re used to it” but there was a time you weren’t. Medical treatments can be hell but much more bearable if temporary.

Ray Hall
Ray Hall
3 years ago

Dear Dr ” Smith”
thank you for your work .Your account shows bravery and moral courage .
Don’t beat yourself up. Do ignore Daloonik Jim.

hughrosetrian
hughrosetrian
3 years ago

“….we do not have massage table-style beds with holes for their faces.” Why not? Any competent upholsterer could churn them out in wipe down material in no time.

Dan Owen
Dan Owen
3 years ago
Reply to  hughrosetrian

And why not after nearly a year of this?

Last Jacobin
Last Jacobin
3 years ago
Reply to  Dan Owen

Good question. But not one a busy junior doctor can answer. Maybe ask the Health Secretary?

Muscleguy
Muscleguy
3 years ago
Reply to  hughrosetrian

it’s not a matter of upholstery a modern High dependency bed is a highly expensive hi tech piece of kit with a bespoke mattress which must meet sterility standards.

Your average upholstery could NOT meet those.

Julia Moore
Julia Moore
3 years ago
Reply to  Muscleguy

Could make face hold ring-shaped cushions though, very early and cheaply… Massage practitioners use them all the time.

hughrosetrian
hughrosetrian
3 years ago
Reply to  Muscleguy

You could make them as pillow type, single use disposable additions or with single use disposable covers. There is no “can do” attitude in the NHS. Too full of “not invented here” jobsworthies. Only read Julia’s comment below after posting.

Heather H
Heather H
3 years ago

This is a heartbreaking read. You are a great doctor, because you obviously care so much for the patients and their families, and I’m sure the rest of the team does as well. Much love to you all.

Claire D
Claire D
3 years ago

At last, thank you UnHerd, and thank you to all the medical staff immediately involved in this situation.

John Lamble
John Lamble
3 years ago

All this was foreseeable. In June 1944, the hospitals were ready for D-day, fully staffed and ready for a deluge of casualties; in fact about four times as many as occurred, thank goodness. There certainly would not have been more time to prepare these than the current shower of jobsworths have had. In practice although a second peak of covid infections has seemed certain through the summer, it seems that virtually nothing has been done to prepare. One might say that, in a well-run society, heads would roll, but I’ll bet they won’t. Employment in so much of ‘public service’ means nothing but a pass to be incompetent, irresponsible, idle and bossy. If only we had politicians ready to tackle these problems but it seems they are cut from the same cloth.

Last Jacobin
Last Jacobin
3 years ago
Reply to  John Lamble

Why blame the public servants for the quality of the politicians? Public Servants have been telling politicians for years there is an imminent risk from Pandemics and we need to prepare, and that the NHS as currently funded will be in trouble. Those public servants (often Trade Unionists) are often described as seeking only to build their own empires and worth. Now they’re proved right it seems a little harsh to criticise them for lack of preparation. Public Servants didn’t decide on ‘Eat Out to Help Out’.

JR Stoker
JR Stoker
3 years ago
Reply to  Last Jacobin

It’s not the funding, it’s the organisation. Lions led by donkeys, or in this case administrator donkeys

Last Jacobin
Last Jacobin
3 years ago
Reply to  JR Stoker

Eat out to Help Out? Was that an NHS recommendation?

Emma Miller
Emma Miller
3 years ago
Reply to  John Lamble

Completely agree, and the people responsible at “Public Health England” are not even (at least not publicly) questioned and held responsible.

But also astonishing how Sage, Valance and Witty, whose tenure in charge should have expired months ago (after spouting fake data and fear inducing worst case scenarios) are STILL there.
It all seems endless propaganda dragging us downhill.

Gerard A
Gerard A
3 years ago

A heartbreaking account, but one that highlights the wasted 6 months since Covid died back in April/May. Billions ( maybe 10s of billions) have been spent on Track and Trace and Mass testing to no real effect. Yet the NHS still s does not have the right PPE, the right beds, and given 20% of the patients caught covid in hospital not the right isolation and infection procedures to deal with the second wave.

Fraser Bailey
Fraser Bailey
3 years ago
Reply to  Gerard A

Yep, it’s the No Hope Service. Equally, Public Health England must be the most inappropriately named organisation of all time.

The deaths of approximately 70,000 people have now been ascribed to Covid in the UK. That is one sixth of all deaths since Feb/March. However, about half of those were ‘with Covid’, based on PCR tests that are criminally unreliable i.e. a huge amount of false positives. So, we are now at perhaps one twelfth of all deaths.

Moreover, a huge amount of the ‘with Covid’ deaths were the consequence of criminally disastrous politicies with regard to nursing homes. And, of course, about 20% of those who really did contract Covid did so while in hospital for other treatments or illnesses.

Yes, there were excess deaths in March/April, but it seems that all-cause deaths are now at, roughly, normal rates for the time of year. In Ireland and Sweden, all-cause deaths are no higher, and possibly lower, than in an average year. And for this we are destroying the economy and millions of lives.

More business will be killed by the reaction to Covid than people killed by Covid.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Fraser Bailey

Portugal and Germany no longer accept PCR testing as even remotely reliable. Average deaths per year are also heavily manipulated figures, dependent on the range of years used, the particular month chosen or excluded for analysis, etc.

Claire Olszanska
Claire Olszanska
3 years ago
Reply to  Fraser Bailey

I’m hoping you were as vocal as when the mines, steel works and shipbuilding industries were killed plus the others.

Barry Coombes
Barry Coombes
3 years ago

Well thank God the government hasn’t spent the last year destroying the economy and so we will be able to fund the NHS and all the other public services we rely on for decades to come. Oh, hang on…

Fraser Bailey
Fraser Bailey
3 years ago
Reply to  Barry Coombes

The government does not depend on ‘the economy’ to fund the NHS and all the other nonsense it provides. Instead, it simply prints and borrows money. Of course, this will lead to Paper Money Collapse, and Covid has brought forward this inevitability by 20 or 30 years. If the government attempted to fund all its nefarious activities out of taxation it would destroy the economy totally.

Last Jacobin
Last Jacobin
3 years ago
Reply to  Fraser Bailey

Looking forward to the international co-operative anarcho-syndicalist future!

Muscleguy
Muscleguy
3 years ago
Reply to  Fraser Bailey

Actually it won’t affect the currency because every single country with a fiat currency has done the same at much the same time so exchange rates have hardly been touched despite the mass quantitative easing.

Swiveleyed Loon
Swiveleyed Loon
3 years ago
Reply to  Muscleguy

Oh, right.
Bitcoin?

Juilan Bonmottier
Juilan Bonmottier
3 years ago

This is a horrifying read -but in order to understand reality properly I have to try to read it critically and objectively and think a little about what the article does not tell.

How many patients are we talking about here? How many beds in the unit? Where is the hospital -is it typical or atypical of Covid wards up and down the country? How representative of all those who have contracted Covid are these particular patients? When was this article written- at what point in the pandemic? What was the writer’s intention -to terrify the bejesus out of everyone and make them understand the risks? Or to find some catharsis for their own understandably dreadful and difficult experiences of caring for the sick and dying? And how representative is this junior doctor of the general experience of the medical profession?

The inference of the piece throughout appears to be that we the public, not present in the hospitals, just don’t get it -we are absent and as oblivious as the wife who just doesn’t get how ill her husband is -but the article does not give us a sufficiently prescient or detailed account of the facts to allow us to get it -so in that regard I found the account rather infuriating. I know what I am meant to conclude from reading it but I can’t make that conclusion without having a better account of the facts and I’m made suspicious by their absence, so it’s not, in my view, a particularly helpful piece in this regard.

It is undoubtedly an interesting, moving and thought provoking account of this junior doctor’s personal experience but in the context of the current scare, with so many questions in people’s minds and considering the omissions within the piece, is it not just a bit of an example (again) of something rather incendiary and scaremongering?

Alan Thorpe
Alan Thorpe
3 years ago

There is an obvious solution. End the tyranny and let the families into the hospital.

Last Jacobin
Last Jacobin
3 years ago
Reply to  Alan Thorpe

And then the families die or pass on the virus to others who will die.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Last Jacobin

Coward. You’d let your mother die alone? Oh no, you’d see it as selflessness, not infecting others no doubt.

Last Jacobin
Last Jacobin
3 years ago
Reply to  Aaron Kevali

Don’t be silly. My mother wouldn’t want to risk infecting me or the other people she loves and I’d respect that.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Last Jacobin

Soulless modern man. No further comment needed.

Muscleguy
Muscleguy
3 years ago
Reply to  Aaron Kevali

My mother died early November. Peacefully in bed in a dementia home without Covid in New Zealand.

I could not go to the funeral because of the Covid isolation rules. It just was not practical. I wrote her a poem instead and my daughter read it at the funeral. I did what I could.

The world is not a perfect place and the perfect should never be the enemy of the good enough in the circumstances which is where we are now.

Claire Olszanska
Claire Olszanska
3 years ago
Reply to  Last Jacobin

Surely at this stage (ie more PPE available – or am I being optimistic?) there is room for manoeuvre and relatives could quarantine afterwards as people do when they come back from holiday – well the considerate ones do.

Alka Hughes-Hallett
Alka Hughes-Hallett
3 years ago

Sad account . People who work with life & death.

If a soldier wrote a day of his life at war , it would be just as moving.

Jane , have you not been prepared for seeing people dying in great numbers in a hospital ICU? Be it of COVID or other diseases or accidents? Did you expect something different ?

This is a heartfelt account , no doubt , but it is an ICU of COVID patients . It sounds terrifying , like a group of any other sudden serious illness . But it need not be. A more humane , kinder approach might be to allow loved ones to see you through to the other side. That’s what I think I would like. Not wheezing machines and aliens around you that you fail to recognise in your last moments . That is more distressing than the account .

Aaron Kevali
Aaron Kevali
3 years ago

Sure, if that soldier were guarding a prison camp. The governnment has created this crisis, and exacerbate it weekly.

Steve Wesley
Steve Wesley
3 years ago

A sobering article which made me reflect on my selfish dissatisfaction regarding going out, wearing a mask and all the other inconveniences I’m apt to get annoyed about. When I hear the figures reported, do I consider that each of those numbers represents a life and someone who is loved by others? I confess that I don’t as it’s out of sight out of mind.

This doctor is being honest about the limitations to medical care and the fact that she isn’t a miracle worker. Her honesty in admitting she feels inadequate to the situation reveals that she hasn’t become innured to the plight of her patients.

No system and no practioner is perfect, but I’d like to thank this doctor and all the other medical staff for doing the best they can.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Steve Wesley

She is not inadequate, she is doing her job. The issue is how we are reacting to this virus and treating it as something we can actually stop. The worst suffering I have ever seen came from fighting the inevitable and in the process sacrificing dignity and actual love.

And you are not selfish for wanting to live normally. Because you are actually healthy (I’m guessing).

Dan Owen
Dan Owen
3 years ago

This seems a fair account – I wonder if the difference between now and previous respiratory seasons is the increased isolation of the dying? (This is an institutional decision). The heart breaking account is not what managing large complex systems is based on. The main factors are Quality Life Years lost plus a) mortality, b) ICU c) Hospital Admitions (For, not with, and not those catching it in Hospital), d) in hospital infections, e) symptomatic cases presenting at surgeries (COIDS?) that subsequently test positive (given FP rates at least 2 tests to confirm and each positive aggregated to individuals) ………….Think that should cover it. Thank you for the article. My take away is regarding resourcing rather than plague.

Richard Kenward
Richard Kenward
3 years ago

Dr “Smith” thank you for the heartfelt insight into your day. I sincerely admire you and all your colleagues for what you’re doing day in day out. Frankly, I don’t know how you cope mentally with what is happening to you and others on the front line right now. I will always clap for the Doctors, Nurses and Carers who are all heroes in my eyes but I will never again for our not fit for purpose NHS and PHE. You really are lions led by donkeys!
Wishing you all the best for the New Year and to finally easing your daily burdens with the vaccine roll out.

Chris Milburn
Chris Milburn
3 years ago

From a Canadian doc – if you look at the “curl” of the COVID curves, the known seasonality, and the “herd immunity” (sorry, politically incorrect term these days) expected, it’s most likely that we are already cresting this winter COVID season and will be on the way down by later in January in most countries (especially those who had a significant number of cases – and thus some degree of herd immunity – in the spring). My prediction is we docs will be vaccinating like crazy in the next month, and even if the number vaccinated is clearly far too low to explain it, the case curve and mortality curve will both be on the way down, and we (and the politicians) will pat ourselves on the back publicly and take credit. At least that’s what my somewhat cloudy crystal ball says.

Banned User
Banned User
3 years ago

Nightmarish situation, thanks for this piece. Must be very difficult for hospital staff to face this day in, day out.

Fortunately I live in Tasmania where we’ve had very few cases, and none at all for a long time, with a generally well-managed response. I hope countries like the UK and the US can eventually get their acts together, and treat the current chaos as a very harsh lesson to be learned.

In the meantime, I hope as many people as possible read this article to remind themselves of the fate they need to try to avoid.

Martin Black
Martin Black
3 years ago
Reply to  Banned User

Mate, I’m in Melbourne and no on in Australia can boast that we’ve done any better than the UK or USA. You may have noticed we’re an island. Our lack of cases has nothing to do with our moronic hysteria and lockdowns – which have been equally as destructive as those in the UK and USA minus the pretence they are part of coping with this year’s seasonal flu.

Banned User
Banned User
3 years ago
Reply to  Martin Black

We’ve done very much better because we’ve realised (so far at least) that efficient, level-headed lockdowns and contact tracing result in very much less transmission, and we have sufficient organisational skills and resources to put this into practice.

This is in stark contrast to the the uncontrolled transmission in the UK and USA, the result of laughably inadequate policies that change depending on the shifting moods of the idiots of charge.

The figures speak for themselves but you obviously think you know better than the scientists.

Michaela Simmons
Michaela Simmons
3 years ago
Reply to  Banned User

With every possible respect, but this is a nonsensical comparison in about every respect. Australia, by mass alone, is an entire continent not merely an island country like the UK. The former is an exceedingly sunny, naturally Vitamin D rich place whereas the latter is a sun depleted one for most of the year. Lastly : population density might have a LOT to do with it. London, Birmingham and Manchester alone contain MORE than half of your vast country’s ENTIRE population. No meaningful side -by-side is possible. Gemany & the UK, maybe. But in terms of infection control, Germany is no better than the UK.

Jules jules
Jules jules
3 years ago
Reply to  Banned User

A virus doesn’t stop existing because you prevent it to spread. It waits until it finds a new host, a Virgin territory.
When Australia will open again, the virus might spread and they will experience their first wave. Unless they get all their population vaccinated. I hope they get it on time for their sake. Or they’ll have to lockdown all over again. As a remote island, they might afford this strategy, although my guess is much irrevocable damage was done in the trade off. Another guess is that this strategy is very dubious or straight out unsustainable when you are located in proximity to countless other countries and your economy and culture has been tied to the free circulation of goods and populations for thousands of years.

Banned User
Banned User
3 years ago
Reply to  Jules jules

We’ve had a first wave, and it was rapidly shut down by firm and well-organised lockdowns. Victoria had an alarming second wave, but that too was shut down by resolute action that earned global praise.

This approach could have worked elsewhere but the intelligence and commitment simply weren’t there, and continue to be patchily applied.

G Harris
G Harris
3 years ago

Rattling innocents alone in their death throes with little comfort never makes for a comfortable read for anyone with a sympathetic bone in their body, but let’s not forget that there are literally millions of others suffering out there in abject misery because of covid restrictions and whose personal stories are yet to be told and most never will.

Athena Jones
Athena Jones
3 years ago
Reply to  G Harris

More suffering from Covid restrictions than Covid itself. I remain curious as to why a bad Flu season makes its way around the world with the same sorts of outcomes but Covid does not. From the look of it, the more lockdown the worse the outcomes.

Signme Uplease
Signme Uplease
3 years ago

This. Breaks. My. Heart. Given that the survival rate for this disease is so high, I cannot believe this is all happening. I’m considering suicide because I absolutely could not face these circumstances, nor would I want to put my family through it. I’m sixty-one and live alone. We live in a sick culture – physically, emotionally, morally, spiritually. We’ve done this to ourselves and it’s a nightmare. And it will only get worse with the politicians behaving as they do.

Ray Hall
Ray Hall
3 years ago
Reply to  Signme Uplease

I hope that you mean that you would consider suicide if you became seriously ill. If you have thoughts about suicide and are not seriously ill, please seek help as you are obviously an intelligent and sensitive human being .Depression is a swine but can be treated

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Signme Uplease

Don’t top yourself Signme, we know it’s tough and we are a very sick society. But this too will end. And when it does, you’ll be glad you didn’t.

Hosias Kermode
Hosias Kermode
3 years ago
Reply to  Signme Uplease

Please don’t ever consider that. I’m 72 also alone but determined to be positive. This is an awful account, but we need to read things like this. It would be helpful to have insiders write every day to update us on the detail. I read points of view from all sides. I watch all the Lockdown TV experts. All have points. All have expertise. All have limitations. We won’t be able to see the truth of this until years after it has passed, but in the meantime surely our hearts must go out to the families so affected, the people dying in this horrific fashion and those doing their very best to care for them.

stephen f.
stephen f.
3 years ago

I cannot imagine ever accepting being forbidden from the side of my: mother, father, sister, brother, child…any prophylactic protection that attendants use is fine for them, but not immediate family? If someone had told me 40 years ago that this would be how citizens will be treated in our lifetime, I would have said-“Maybe behind an iron curtain, but never here…” Not me. Not my family.

Claire Olszanska
Claire Olszanska
3 years ago
Reply to  stephen f.

Actually during diphtheria outbreaks in the 30s, and before I assume, the same applied. Children died alone. Probably same for most infectious diseases. I don’t agree with it though at all. Fortunately we’ve not had to deal with serious infectious diseases for many years. Not sure what Iron curtain has to do with things but Unherd commentators can’t help politicising things that don’t need it.

Claire Olszanska
Claire Olszanska
3 years ago

The down vote is for what part of what was said?

hazeyqq
hazeyqq
3 years ago

But we’re not in the 1930s. I spent months in an infectious disease hospital and also a period of time isolated on a “normal” hospital ward that got locked down during an outbreak. The forner had their own crematorium and rooms within rooms for patients with ebola, etc. Unless something like ebola – the nursing staff told me that during that awful death you wouldn’t know if someone were with you – it was practical to have visitors. There were protocols but none of this 15 mins with only 1 person.

Claire Olszanska
Claire Olszanska
3 years ago
Reply to  hazeyqq

Oh I agree that visitors should be allowed. Absolutely. Wasn’t the point I was making.

Athena Jones
Athena Jones
3 years ago

We are indeed fortunate that improvements in living conditions, particularly hygiene and sanitation, led to a greatly diminished incidence of these diseases and a flatlining of mortality. Much of that happened in the first half of the 20th century.

nabarreria
nabarreria
3 years ago

what is shocking is that they have. left people to die alone like if they were animals when they could be assisted by their families during that time, the family could even self isolate after visiting them, and if they were under 60s their chances of dying if they get covid are extremely low, we have to protect the vulnerable only, not everyone, this is the total lack of humanity this society has created

Malcolm dunn
Malcolm dunn
3 years ago

I wonder if this article is genuine?

Annette Kralendijk
Annette Kralendijk
3 years ago
Reply to  Malcolm dunn

It does read like a composite.

Andrew Martin
Andrew Martin
3 years ago

I am sorry that we are the position we are but the Medical establishment in the UK and America have refused to investigate good treatments for this disease which have been proven elsewhere. Not surprising though after the Hydroxychloroquine trials in the UK which were a disgrace to the Medical establishment here. How long did it take them to realise VitaminD intake is important, for them to say that ever elderly person in Care homes will get 400 i.u when in fact higher doses are needed to build immunity. The drug Ivermectin has been proven to halt the progress of the disease in most cases but not a sniff of recognition by the powers to be here. Dexamethasone has been hailed as the all conquering drug but its efficacy is like Remdesivir mediocre.

Kenneth MacKillop
Kenneth MacKillop
3 years ago

Interesting first-hand account of the state of things in-hospital currently.

It is my opinion that the pandemic is over, at least in my region of northeast US (Mass. specifically for me).

Lest anyone be outraged at this statement, I should clarify that a “pandemic” by its longstanding and proper definition REQUIRES a very high level of EXCESS (over historical long-term baseline) deaths, and we largely simply have NO excess whatsoever now in much of the West.

I have a friend (or maybe I should say “had”) who is an MD and works in a local hospital. I have not corresponded with him since summer of 2020 I guess — probably early summer or even late spring. But his thinking on SARS-2 had been clearly dominated by his own personal experience of in-hospital death from what was happening during the REAL (and I would argue ONLY) pandemic surge from SARS-2 in our area. Infections peaked around the beginning of April, and I think mortality peaked some time later in April with the lag of typical survival time between infection and death.

Clearly, to me anyway, one of the distinctive emotional elements of SARS-2 death is the fact that patients die by gradually increasing deprivation of respiration. It is the same in lung cancer and sometimes other forms of pneumonia from infections secondary to flu and so forth. But I do not think that medical staff are used to seeing such a large amount of this as SARS-2 has induced, and that probably includes a lot of those who die WITH CoVID-19 rather than exclusively because OF it.

As a practical matter, looking back now, I think that some sort of hospice care would have been more appropriate. Maybe this needs to be added to hospital services now. Natural and vaccine-induced buildup of herd immunity will probably put the issue to rest before a reasonable public policy debate and resolution can be achieved. But I would be interested in a realistic quantitative measure of what percentage of ICU patients have recovered — I doubt it is very large. And the fact that many were actually KILLED by inappropriate ICU treatments earlier on MUST be factored into this — the lower numbers of patients being now killed must NOT be included!
It may, or likely is, impossible to do an accurate study of this. Too many confounding factors and too little reliable data.

I feel a bit for those still grinding things out in medical intensive care setting, like the writer. But this does not excuse a hugely ill-advised and destructive public policy strategy, largely in an ill-advised mimicry of an evil communist gov’t (CCP) which deserves both attention and contempt, but no admiration at all, that still persists.
Maybe our societies have become too rich, too privileged, too entitled, too much embued with group-think and conformity, too thoughtless and lacking in analytical aptitude, and just too fragile and weak and spineless (both public and leaders, if we really have any such now, alike).

Comparing the way century-ago versions of these same societies handled the Spanish flu, arguably two orders of magnitude more virulent and significant by any reasonable measure, should make people at least scratch their heads a bit, and maybe feel ashamed.

I enjoyed the article, especially because the writer seems to have avoided imposing her own moral judgements amidst her observations. There is far too much fingerpointing in our modern societies now, and this is methinks reflective of a weak and fragile society lacking in character and courage and judgement.

Aaron Kevali
Aaron Kevali
3 years ago

BLASPHEMY.

But totally correct.

Jack Shaw
Jack Shaw
3 years ago

“Jane” I cried over and over reading this – it’s the most raw, human story I’ve ever read. Thank you for sharing, please do let us share your burden and write again. I take my hat off to you and others standing in front of this pandemic with the courage and empathy that you do.

I hope your account makes lockdown sceptics stop and think. I for one follow the rules as much as possible, especially because my partner is clinically extremely vulnerable, but this will be the reminder I need.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Jack Shaw

Another vulnerable person… well I will cease my skepticism when every Tik-Tok video of dancing nurses is taken down for being grossly offensive and insensitive.

Jack Shaw
Jack Shaw
3 years ago
Reply to  Aaron Kevali

Aaron, if you read the piece and you’re left with concern about nurses dancing on TikTok then you need to check your compassion radar. You can equally have concerns about the lockdown and mission creep if you will, but you can’t deny that people are dying in their thousands.

They say people who dislike immigrants the most are the ones with the least contact with them. I wonder if your ignorance is a product of distance too.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Jack Shaw

Liar, liar, liar. Nurses who dance during a pandemic, while simultaneously telling us how serious it is and how we have to take it deathly seriously, well pardon me Jack, but something is off here. And it is not my compassion (although you certainly have compassion, right?RIghteous man, so caring, so….fake.).

On an average day in Britain 1600 people die. Average. Normal day. In Britain. I do not deny people are dying. Maybe even a little more in excess than usual. Tragic for those involved, but also mostly inevitable and elderly.

I have several family members who work as nurses and associated clinical staff, including a radiologist and occupational therapist.

Incidentally, I live near Luton (white British have been a minority here for quote a while). Not sure why you brought up immigration, but Is that enough exposure for you?

Frederik van Beek
Frederik van Beek
3 years ago

It is nothing less than a crime against humanity to let old and frail people die all alone because of such a relatively harmless virus.

Jason Burridge
Jason Burridge
3 years ago

It’s not reletively harmless to them. But governments have rejected the proposal of focused protection for them.

Alex Lekas
Alex Lekas
3 years ago
Reply to  Jason Burridge

Well, yeah. Why settle for protecting the truly vulnerable when you can control the broader population?

Last Jacobin
Last Jacobin
3 years ago

They’re not all old and frail. Did you read that part? Working age and working people who are very sick and may die.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Last Jacobin

Average age of the dying please. Say it.

Last Jacobin
Last Jacobin
3 years ago
Reply to  Aaron Kevali

Posted this sort of thing before. Best to do your own research but I’d avoid youtube if I were you. These numbers come from Office of National Statistics (ONS).

Average life expectancy from birth is about 80 to 83 depending on which definition you use. Average age of death from Covid is 83.

However, average life expectancy if you make it to 80 is 90 years. If you make it to 60 it’s 87 years and if you make it to 70 it’s 88 years. If you die from Covid between the ages of 60 to 79 (one of the 17,343) you would normally have expected to live for a further 9 to 27 years at the time of your death.

The figure that would be really useful would be comparative life expectancy at 60, 70, 80 etc for people who don’t catch Covid compared to those who do and data on severity of other co-existing conditions but we don’t have that data yet and won’t have until retrospective detailed analysis is undertaken by medics. (who are a bit busy at the moment)

Below is the breakdown for deaths from Covid up to mid-December. 54% over 80, 46% under 80, 8% under 60, 38% between 60 and 79. So 46% of people dying of Covid died before their life expectancy at birth.

Age/Female/Male/Indeterminate/Unknown/Total
17,92727,5371145,466

0 – 19 yrs12 15 0027
20 – 39130 166 10297
40 – 591,1132,033003,146
60 – 796,04811,2950017,343
80+ 10,62414,0280124,653
Unknown age00000

(Sorry about the formatting but I copied the table and it doesn’t paste well)

I’ve no doubt you’ll challenge these numbers and best check for yourself but let me know if they’re at all helpful.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Last Jacobin

Your statistical picture is appreciated, you clearly know how to handle data. I couldn’t read the table, it must be formatted better, but the percentages do rather prove my point, that the young are largely unaffected (“CLOSE THE SCHOOLS!”), and that this is a disease that affects the aged. You’re no doubt one of those people who claims that AIDs isn’t a gay/junkie disease. 8% of deaths below 60, eh? How close to 60? What co-morbidities? Overweight? Immunocompromised? Only 400 people have died in the UK so far from COVID without comorbidities or advanced age (almost the same thing really).

“So 46% of people dying of Covid died before their life expectancy at birth.”
I reject this statement as nonsensical. I am now 31, and could theoretically be dead next week from a contagious illness (though not COVID at least, according to your data). Since when did disease not factor into a population’s average life expectancy, and why is dying before age 90 if you’ve made it to age 80 already to be considered a tragedy? Madness.

Lindsay Gatward
Lindsay Gatward
3 years ago

It seems most deaths of those being treated for illness or frailty end in a similar situation of respiratory collapse – The inhumanity of only robed and masked strangers being present must so deepen the sadness of those dying but it seems that is increasingly promoted – So makes the case for ‘medicines’ that blur and hasten the end but it seems that is increasingly demoted – Our technology success seems to ironically contribute to our humanity failure?

Michelle Johnston
Michelle Johnston
3 years ago

45,466 people had died from Sars CoV 2 by the 16th December. 377 were fit and healthy between the age of 0-60. 92% were Co Morbid. (ONS)

This isn’t the first experience i have had to day where the implication is that active/ younger cases are more prevalent that the official numbers suggest.

When cross referenced with the NHS figures they look much the same.

382 fit and healthy have died of C 19 between the ages of 0 60 up to the 23rd December out of a total of 47,749.

In detail Fit and Healthy Deaths

0 -19 >>> 6
20-39 >>> 44
40-59 >>> 334
60-79 >>> 821
80 plus >>> 777
Total >>> 1,979

Co morbid all age bands 45,770.

I am struggling too see how 70% of the population of England below the age of 55 who are fit and healthy so about 35 Million are a big part of the hospitalisation and can only appear anecdotally, after all 382 people spread over all hospitals over 9 months is a small number.

Elsewhere the stats for hospitalisation 0 60 are 3/4 per 100,000 by comparison 85 + are 170 per 100,000.

G Harris
G Harris
3 years ago

Hospitals the world over only have a certain amount of ICU beds available by design.

Some more, some less not least because, not to put too fine a point on it, they are an extremely expensive service to maintain as they require highly trained staff to man them.

It is as much a political choice as it is a medical and economic one.

It sounds brutal, but it all boils down to risk and cost benefit ratios. The same reason we didn’t have piles upon piles of PPE sitting and decaying in a warehouse somewhere doing nothing at huge cost waiting for an occasion that may or may not have happened in our lifetimes.

In normal times there are ‘just’ enough ICU beds that they can usually cope with what is usually thrown at them on a daily basis, but just occasionally they can’t and this often makes the headlines provoking the ‘is this what our society is coming to’ type handwringing we’ve long become used to.

Covid is an extremely unusual event. A real outlier in terms of the deleterious effect it is having on a very specific, limited by design and choice capacity uniquely placed to deal with it.

The question is what happens in a post covid world with immediately decimated economies where such priorities will become even more difficult?

Do we now expect our hospitals in future to have hundreds upon hundreds of empty ICU beds with lots of highly expensive trained staff milling about doing nothing on the off chance of another pandemic?

For that, essentially, seems to be what a good many are now agitating for.

Andrew Hall
Andrew Hall
3 years ago
Reply to  G Harris

I think you’re suggesting the reason there may be disproportionate numbers of under 60’s in ICU is they are given preferential access since they have fewer co-morbidities and potentially more quality years of life ahead of them than their elders? It would seem logical given a shortage of staff and ICU beds during a once in a generation epidemic. In effect, the NHS has put the entire hospital system on a war footing fttb.
It worries me that there seems to be precious little happening to bring new therapies to Covid19 patients. I do wonder whether that is in part because the technology race to find entirely new vaccines is more profitable and also professionally rewarding for the research teams involved. That isn’t wrong in itself but there seems a lot of bad politics surrounding attempts to find – or block research into – creative re-purposing of existing out-of-patent treatments. A number of small improvements in preventative medicine and reapplication of existing therapeutics may prove as important as a good vaccine.

G Harris
G Harris
3 years ago
Reply to  Andrew Hall

Well, when you have a limited resource, be it beds, staff, drugs, or equipment, you’re going to have to implement some form of ‘triage’, as unpalatable to some as that might seem, and that has to be based on someone somewhere’s ‘subjective’ criteria.

Whether that is based on age, comorbidites, degree of illness and chances of survival is one of those hard choices most of us won’t have to make, but someone will.

Vaccines are often presented as the panacea, the cavalry, the light at the end of the tunnel etc but their impact is not only overplayed their potential downsides are rarely if ever mentioned.

Aaron Kevali
Aaron Kevali
3 years ago

Michelle, thank you. Actual data presented clearly and unambiguously, instead of fear mongering and virtue-signalling.

In short, this whole thing has been a massive over-reaction of the most epic proportions and we will look back on this period of history the way we look back at Princess Di’s funeral, 70’s trouser flares, the 2003 Iraq War and 80’s mullet hair styles.

wesley.sawkins
wesley.sawkins
3 years ago

I am grateful to this doctor for her honesty and the agonising time they are going through. “When we think that these patients have suffered enough, and are unlikely to ever recover, we start talking about making them comfortable.” This is the coldest sentence in this article. Normally you would, if you’re lucky, have your relatives around to fight your corner. Not all doctors are as good as the author, I do worry we are effectively stepping close to euthanising people here: “we give them morphine to reduce their respiratory drive… benzodiazepines to lower their anxiety… other medications to prevent them from needing to cough. We then take off their masks.” So you take away the biological drives to breathe then remove them from something which is keeping them alive, they are so sedated they won’t make a fuss and then they die alone. What new hell have we entered.

Andrew Hall
Andrew Hall
3 years ago

My elder daughter worked in ITU at a large London teaching hospital before becoming an outreach resusc nurse and recently returning on her second secondment (April and now January) to her previous employer’s ITU/HDU/ICU department. On Friday In a phone conversation following a 4×12.5hr week she commented in passing that her patients were predominantly men in in their 40’s and 50’s whereas last March they were elderly and included more women. She did not know whether this was due to a better medical understanding of who was most likely to benefit long-term from ventilation or whether staff shortages were leading to rationing. There was no shortage of equipment and oxygen on the wards despite taking in highly dependent patients from regional and outlying hospitals, as far afield as Guernsey.
I’ve seen a fair amount of discussion since March about the propriety of ventilating elderly, and very sick Covid19 patients, given the suffering created by the therapy itself alongside the weird full PPE technology-dominated environment lacking human contact, despite heroic efforts to communicate your humanity from behind the mask and full protective kit. You wouldn’t choose that path for your patient unless the prospects of a recovery were fair and maybe that factor is at work in this situation. I wonder if we will learn something from this pandemic about the way to manage our final hours if a hospital ward is to be our last stop on the way to eternity. Clearly we can’t send a dying Covid19 patient home but maybe we shouldn’t allow them to die in a star wars environment either,.

Athena Jones
Athena Jones
3 years ago
Reply to  Andrew Hall

Well said. Unfortunately little will change until science-medicine can be extracted from the Darth Vaders of the drug industry and its systems extricated from the materialist reductionist mechanical mindset of modern science-medicine. Yes, absolutely the techo toys and whizz-bang whirly-gigs have on many counts, wrought miracles in the areas of surgery and crisis/trauma. However, they have utterly failed to bring better health or indeed on most counts, to bring cure.

No pill, machine or vaccine will ever bring good health because, by their nature they are mechanistic, artificial, experimental, meddling and sourced in more ignorance than knowledge in regard to how the human organism works. They are also sourced in a profit-driven agenda which does not have the patients’ best interests at heart and which seeks to dismiss utterly, natural function and knowledge of natural function, unless it can be used to make money. Unfortunately, in such an equation, consciously or unconsciously, health is an inconvenience.

Claire Olszanska
Claire Olszanska
3 years ago
Reply to  Athena Jones

Vaccines have worked though – haven’t they?

Stuart Bennett
Stuart Bennett
3 years ago

It’s a tough time to be a healthcare worker but we can hope the vaccines are all they’re cracked up to be and that this will be over in a few more months. Assuming PHE can be bothered to put in some extra hours on sundays….

Apart from by Douglas Murray in these pages, It’s never discussed that this virus was visited upon us, either deliberately or by design, the result is the same and so is the responsibility, by another nation state who have gone completely unchallenged by all areas of the press and government.

I am also deeply troubled by the choking off of information about who the victims are, age, comorbidities etc. This matters in a liberal democracy. It’s been said 1000’s of times before and studiously ignored every time that just because you had a positive COVID test 28 days before you died, in no way does that say that it killed you. Nothing has been done to address this issue for that last year.

To echo some other people’s comments, it’s clear many of us have lost our understanding of mortality. Humans die, every single one. One rarely gets to decide when or how that moment comes. The shrieking self regard from some people is insufferable. It’s nice if you can live to 95 but you don’t have a right to it. It should be a reminder to everyone to make your life matter today because there’s no guarantee you’ll have one tomorrow.

G Harris
G Harris
3 years ago

And here’s yet another very recent example from my personal experience.

A dear, dear lady, whom I have known for many years, a founder of the local school playgroup and hugely well-liked figure across the social spectrum, has just had a serious relapse of the cancer which almost killed her some years ago.

‘Thanks’ to Covid restrictions, unfortunately for her and her close knit family, she is in her local hospital apparently very close to death unable to get adequate access to the scans and treatments that might save her or, perhaps more importantly given the near hopeless circumstances, to see her loved ones in what might well be her last hours on this earth.

All despite her and her family having diligently followed ‘the rules’ throughout sadly.

Perhaps the anonymous author of this heart rending piece about covid can follow it up with a similar piece regarding the barely talked about legions of those like my friend above who will indirectly fall victim to the ravages and associated injustices of covid without actually dying specifically of it?

Bill Tattersall
Bill Tattersall
3 years ago

This is a tragic story. I’d like the doctor to explain to us how it compares with other years’ seasonal flu. Are the deaths from Covid more horrible than flu deaths?

G Harris
G Harris
3 years ago

Don’t be picky.

Claire Olszanska
Claire Olszanska
3 years ago
Reply to  G Harris

It’s the volume.

peter hingley
peter hingley
3 years ago

Thank you for your honesty and effort

Laura Pritchard
Laura Pritchard
3 years ago

Can I ask a question? Are people who have developed severe Covid19 and been treated over a number of weeks still infectious? Sorry for my ignorance but I’m interested in the progress of the disease versus the virus.
Regarding the doctor’s report, it goes to show us all what a difficult job it is to do, whatever someone is dying of.

Steve Swales
Steve Swales
3 years ago

I don’t know about those recovering from severe forms of the disease, but my wife and I had mild symptomatic Covid-19 infections in November and (thankfully) recovered relatively quickly. Quite pointedly, my wife’s employer, our local Acute NHS Trust, did not require any confirmation of her non-infective status before she restarted work after the prescribed period of self-isolation, so I’d assume they must be very confident that the viral infection itself is pretty short-lived. (I’m inclined to assume that the worst symptoms associated with Covid-19 actually stem from the body’s hyperactive immune response to the virus, though I’m open to being corrected on this.)

Laura Pritchard
Laura Pritchard
3 years ago
Reply to  Steve Swales

OK I found an answer to my question. https://www.bmj.com/content
It would appear that people are minimally infectious when and if they reach the critical phase. So what is all the PPE and the restrictions on visits about? From this study, it would suggest that the policies came from experience with Sars Cov1 where peak infectiousness occurred later. I can’t see any reason for withholding family from visiting a severely sick patient with Covid19. If you don’t have Sars Cov2, this is not an environment where you’re likely to catch it. If you do have it, you’re not going to make things any worse – although your behaviour around the rest of the hospital might need to be controlled – just like with any other infectious condition. And of course, you don’t want to make a sick relative weaker with any other infection so that would make sense for the PPE in this environment, I guess. But I can’t fathom any scenario where a loved one should be deprived contact at this extreme phase of the illness and, indeed, the contact might just save quite a few lives.
Meanwhile I wonder when we will get back to considering quality of life at death rather than extreme panic button measures. We’ve only had nearly a year, now.

Muscleguy
Muscleguy
3 years ago

The long period is not likely due to ongoing Covid infection but the fallout from it. The cytokine storms this virus seems very good at causing in some people for eg will burn after the virus is gone.

It also weakens and debilitates people, if their lungs are badly affected it may take some time after the virus has gone before they can be taken off oxygen since it simply takes time for the lungs to heal from that sort of thing.

I had mild Covid and didn’t feel fully well for more than a month after the cessation of symptoms. My body was probably making antibodies which would have been part of the reason but I would also have been generally recovering.

So it took a month after the cessation of symptoms when the virus was long gone before I went for a run.

Andrew Anderson
Andrew Anderson
3 years ago

It would be interesting to know how the three patients mentioned at the end, all between 60 and 64, and the 61-year-old, became infected. Was any of them working from home? We should protect everyone over 60, perhaps even everyone over 55, who’s still working and can’t do so from home, by furloughing them on 100% of their income, plus help with any reasonable additional costs, such as food delivery charges, plus paying their employers’ NIC and pension contributions, all for as long as necessary.

Last Jacobin
Last Jacobin
3 years ago

Well said. I’d add those who are clinically vulnerable and sensibly think about how we manage schooling for children in households with vulnerable people in them.

Unfortunately, the government went down the route of paying employers (rather than workers) furlough and at less than 100% of income. Inevitably, hundreds of thousands – maybe more – of ‘furloughed’ workers are actually working full or part time as that is the only way they get to hold onto their jobs.

Aaron Kevali
Aaron Kevali
3 years ago
Reply to  Last Jacobin

Totally true, the true cost of which we cannot know just yet.

zlopes0
zlopes0
3 years ago

https://covid19criticalcare

From the data in the site above, additional interventions should be taking place with both health providers and patients. Honestly – with all people. It is unethical that it’s not. But there is NO reporting on what the average person can do to help their bodies fight this horrible disease. There is no money in actual Healthcare…

And although there are pharmaceuticals (e.g., Ivermectin & HCQ) that show positive effects but are not FDA approved YET, there is PLENTY one can be taking/supplementing with to offer some protection. The protocol ‘I-MASK+ Prophylaxis & Early Outpatient Treatment Protocol for COVID-19’ (2nd link on the left side of the page) gives a good summary.

Take power back into your hands and treat your body with care. Food either heals you or harms you. And there are vitamins & supplements essential for optimal health.

Charles Rae
Charles Rae
3 years ago

I never thought that I would be grateful for the timing of my mother’s death, but, reading this, I am. She had dementia, and once she caught a cold she went downhill rapidly, pssing away just over a month after she fell out of bed the first time.I was very fortunate being able to be at her bedside, hold her hand and tell her Iloved her. I can’t imagine what it must be like for loved ones not to be there at the end. Years ago,mum was in a coma and she often told me how she had heard doctors saying she didnt have long to live, that poor woman. Even if people seem unaware, they are, and dying in that noisy and troubled environment must just add another level of stress to the process. Honestly, I could shake
all those idiots who havent been following the rules.

Athena Jones
Athena Jones
3 years ago
Reply to  Charles Rae

Taking a look worldwide, the rules don’t seem to make much difference to outcomes.

However, your mother was lucky to have you and yes, even in Dementia and without the ability to function mentally, people are still ‘there.’ Terminal lucidity is both common and recognised.

Pneumonia used to be called the ‘old man’s friend,’ although one presumes it applied to women also, because it ‘took them out.,’ when they were old and sick and in saner times that was seen to be a blessing.

Now we rig them up like robots and get robots to attend them, whether real mechanical ones or humans trained to be robots and call it nursing. It is a travesty of nursing, caring and good medicine.

Claire Olszanska
Claire Olszanska
3 years ago
Reply to  Athena Jones

What about the countries that have very low deaths? Have their strategies failed?

v easter
v easter
3 years ago

OK. Dr “Smith” so now I am frightened. But what is the point of that ? What do you hope to achieve?

Ted Lovett
Ted Lovett
3 years ago
Reply to  v easter

Maybe it’s the natural human desire to share experiences with others? Maybe it’s to encourage us in wider society to take the threat to ourselves and others seriously? Maybe it’s they want us to behave in a way which will not lead to further avoidable misery, disability and death? Maybe this doctor doesn’t have an agenda and is acting in good faith?

Heather H
Heather H
3 years ago
Reply to  v easter

Maybe to get people to take lockdown seriously?!

J StJohn
J StJohn
3 years ago
Reply to  Heather H

Quaranting the vulnerable could have worked. Lockdown cant be taken seriously, it doesnt work.

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
3 years ago
Reply to  J StJohn

The question is who exactly are “the vulnerable” ?

1.49 million people in the UK are in receipt of adult social care (private and NHS and Local authority and direct payment recipients) + there are 1.52 million social care workers (potential transmitters to this vulnerable population). This doesn’t include those that are being cared for by immediate family members.

The population at risk of severe COVID-19 (aged ù‰„70 years, or with an underlying health condition with a fully adjusted hazard ratio – HR of getting severe covid of 1.13 or greater) comprises 18.5 million individuals in the UK, including a considerable proportion of school-aged and working-aged individuals.
Just to put the HR figure into perspective the HR for those > 80 from the same study is 20.6 – the main reason for immunising the elderly first.

How do you quarantine a multigenerational household ? – put all the obvious vulnerable (>70 years) in Premier Inns ? Right now 34% of households in the UK are multigenerational – 9 million homes.

If people can’t or won’t stop mixing with other people, and you have a crap T & T & isolate system, locking them up is the only other alternative if you want to break a train of transmission (as they did in China and NZ and certain parts of S Korea and Taiwan). Yes – a very blunt instrument. Zugzwang (the chess variety)

J StJohn
J StJohn
3 years ago

That’s for the vulnerable to decide.

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
3 years ago
Reply to  J StJohn

Yep. As long as they fully understand the downsides of not quarantining (the NHS may not be able to offer them tip top care) and provided they have realistic options to quarantine if they want to.

Herbert MD
Herbert MD
3 years ago
Reply to  v easter

Feel free to close your eyes tight and put your fingers in your ears if you prefer. Then you’ll never be ‘frightened’ again.

Lesley Q
Lesley Q
3 years ago
Reply to  v easter

Exactly. As if I wasn’t scared enough and already having nightmares about what might happen if I or any of my family become ill, I now know that I will die alone, with no-one to hold my hand. Thanks a bunch. I already appreciate the work that those in the front line are doing, I didn’t need this to make me more grateful, and I certainly didn’t need my mental health blow torched with yet more anxiety.

Paul Aitken
Paul Aitken
3 years ago
Reply to  Lesley Q

Don’t read it then. I struggle to imagine what you thought an article entitled “Inside the Covid Ward” would contain. Did you think that this was going to be a cheery, anxiety reducing read?

LJ Vefis
LJ Vefis
3 years ago
Reply to  Paul Aitken

There’s always a vain hope in the heart of an anti-lockdowner, or a lockdown agnostic, that it might be an “Actually, hey, it’s no worse than normal!” sort of piece. Bloody hell, I only came here because I banned myself from Twitter…. Back to work!

Lesley Q
Lesley Q
3 years ago
Reply to  Paul Aitken

I didn’t read it – apart from the title and the first few lines, which popped up in my inbox.

Les Watts
Les Watts
3 years ago
Reply to  Lesley Q

None of you were forced to read it

Dorothy Slater
Dorothy Slater
3 years ago
Reply to  Lesley Q

Lesley: Perhaps you should ask yourself why you are so anxious that your mental health is at risk of getting worse reading an article about what is going on in hospitals. I live alone – and expect to die alone with no one to hold my hand since I have no family and don’t expect friends to come and hold my hand.

At 83, a cancer survivor, I am at peace with that and although I certainly could live my iife filled with anxiety, I choose not to. Living that way is no way to live no matter Covid. You and you alone are responsible for your anxiety not some article. I suggest you deal with that since after covid, something else is bound to pop up.

Liz Wills
Liz Wills
3 years ago
Reply to  Dorothy Slater

Dorothy, this is profound. Thank you for sharing and I hope the end is a long way off.